DIET FAILURE: Can Weight Loss Surgery Help?

by Dr. Robert Smith

After struggling with a weight problem for years, some individuals reach a point where dramatic measures seem to be necessary.

Weight loss surgery is therefore at times a realistic option for obese persons who have tried every diet and weight loss system available, yet still can’t take off the pounds.

Types of Weight Loss Surgery

• Restrictive procedures that make the stomach smaller in order to limit the amount of food consumed.

• Malabsorptive techniques that reduce the amount of intestine that coming into contact with food so that fewer calories are absorbed by the body.

• Combination operations that use both restriction and malabsorption to achieve weight loss.

How Much Does Weight Loss Surgery Cost?

The average cost for a gastric bypass procedure ranges from $18,000 to $35,000, The average cost for an adjustable gastric banding with Lap-Band procedure ranges from $17,000 to $30,000.

Other kinds of weight loss surgery including gastric sleeve surgery and duodenal switch surgery cost roughly the same as gastric bypass and gastric banding. There are also promising new and minimally invasive bariatric surgeries on the horizon, but the cost is yet-to-be-determined for these new weight loss surgery procedures.

After the main weight loss surgery procedure, a bariatric surgery diet must be adhered to. It’s also likely that additional surgical procedures such as liposuction, breast augmentation or reduction and tummy tuck will be necessary. These follow-up cosmetic procedures usually take place one or two years after bariatric surgery is completed.

Does Insurance Cover Weight Loss Surgery?

Health insurance including Medicare and, in some localities, Medicaid, are starting to cover some or all of the costs of weight loss surgery. It is necessary to establish for your doctor to classify it as a medical necessity as defined by the National Institutes of Health requirements.

If your doctor provides the insurance company with medical documentation that you have a B.M.I. (body mass index) over 40 and that the surgery is medically necessary to treat morbid obesity, the insurance company will probably cover the majority of the cost of the surgery. Your doctor must also state that other weight loss methods have failed and therefore bariatric surgery appears to be the only remaining option.

You may qualify for insurance coverage of weight loss surgery if you fall under one or more of the following categories:

• A BMI of 40 or higher.

• A BMI of 35 or higher with serious obesity-related health problems, including diabetes, heart disease, high blood pressure or severe sleep apnea.

• Women who are more than 80 pounds overweight.

• Men who are more than 100 pounds overweight.

• Both men and women who have been overweight for at least five years.

Weight Loss Surgery Success Rates

The success of weight loss surgery varies by the individual and the type of procedure performed. Lap band and gastric bypass surgery have mixed success rates, while the duodenal switch appears to provide the most successful long-term weight loss (see chart above).

One of the best ways to educate yourself is to post your questions on various weight loss surgery forums and get feedback from others who may have a similar problem or already have undergone bariatric surgery. Take your time and make sure you choose the right bariatric doctor and understand all the weight loss surgery options available.

Weight Loss Surgery: Angie’s Success Story

by Angie, age 38

When I was at my heaviest, I weighed 388 pounds. My self-esteem was at rock bottom. I could hardly walk, and the consequences of a lifetime of emotional eating had taken their toll. I decided enough was enough.

Now that I have my self-confidence back, I am able to shop for normal clothes and avoid the plus-size stores. Weight loss surgery has given me life back, and I couldn’t be more grateful to my doctor and the staff of diet counselors for all their help!

(published April 12, 2010)